MyFit Breast Cancer Journey-Part 5: What's Next?
Updated: Jan 11, 2022
What's next? That's the question I asked the nurse navigator on October 13, 2021. She discussed setting an appointment to meet my oncology and surgical team as soon as possible. She said she would be mailing a guide (this thing was huge!) to breast cancer and treatment as I was in Florida, but decided to remain a patient with the medical team in Charlotte. I had to take notes on the rest of the information she gave me. It was a lot! Genetics, DNA, type triple negative cancer, surgery is outpatient, pathology report would determine treatment steps after surgery, etc., etc., etc... I remember being in bed when she called at 8a, and I wrote all of the information on the back of a bunch of my business cards. She did offer to call back at a later time..."No ma'am, let's do this right now!" My nurse navigator was wonderful though - a kind, gentle, and understanding human who is willing to go out of her way for her patients. I'm not used to seeing that anymore. She made navigating the cancer process less overwhelming. She is a blessing to the cancer center. I found myself trying to take care of her during the process and making sure she was resting and taking moments to breathe. She reminded me who was the patient.
Flashback to biopsy on October 8. I want to give you an idea of how quickly (too quickly) this entire cancer process flowed, and how the patient barely has time to process and think, unless she takes control and puts a halt on things until she can grasp processes and procedures. When I didn't understand, I asked them to repeat. When they "told" instead of "asked", I then said "wait" and I asked "why." Because the mass was tiny, the ultrasound didn't show clearly if it was actually cancer, so a biopsy was done. The doctor took 6 pieces of the mass (I thought, well as small as it is, looks like you have it all right there in a jar!). She also showed me a raised area on a lymph node. It didn't look cancerous, she said, but she wanted to biopsy to be sure. This is where they got me because I later learned that technically a lymph node biopsy doesn't provide true information regarding its malignancy. It should be removed for that analyzation. I was cut in a couple of areas, poked and prodded for what seemed like hours. The end game was the placement of two miniscule titanium clips- one in each area of biopsy in order to alert surgeons, et.al, to the biopsied areas.
In the most vulnerable time of my life, lying on a metal table--cut, poked, prodded after biopsy--I had to make quick decisions and ask questions. Why in the world would you put metal into a cancer patient?! Toxic! I asked them why. They said these are small-scale; it's harmless titanium. I said this cancer is tiny too...yet, here we are...
I chose to have a lumpectomy. This is the package it comes in, I thought to myself. Unbelievable. I was told about this in the middle of the biopsy. It's normalized. After asking questions and knowing that these clips show up during surgery and other screenings to show the area of cancer, I said "SHENANIGANS (my word instead of cursing)!" If I tell them not to place them, surgeons will be poking my breast for the cancer during surgery to find the area and possibly spread cells around (could be happening during this biopsy), and if that is anything like today's procedure, no thank you. I told them to place the clips. My back was against the wall/the metal (literally and figuratively).
I chose surgery because I know myself. One must know herself and prepare and be secure with the answers to her own questions before proceeding. I had been working on my mind and thoughts with powerful meditation practices. However, I knew if I left the cancer in place, I would often wonder: is it growing, where is it, has it spread, how big is it now. I wanted it out. The downside to choosing surgery was wondering if cells were disturbed and "slipped though the cracks." I had to choose the lesser of evils for my mind. These decisions become personal and only the patient can make those intricate resolutions.
On October 25, with my 2-paged list of questions in my pocket (some of them I got from Chris Beat Cancer site) and a spirit of "I come with a loving heart, but don't mess with me," I met my oncology team which consisted of the radiology/oncology breast surgeon and the medical oncologist (chemo doctor).
My surgeon was a breath of fresh air to conventional medicine-patient, knowledgable, human. He spoke percentages, drew pictures, jotted notes in a pamphlet so I wouldn't forget, and he talked about radiation. I talked about the damage from it along with some other questions on my list. He looked as if to say, we have a wild woman on our hands. I would later learn that he was also my bestie's surgeon as well as the surgeon for our former ob/gyn doctor. He must've called me three times during my two day stay in Charlotte, just to check in and to ask if there were questions and to make sure I understood the procedure. I was then scooted down the hall to the medical oncologist. She discussed chemotherapy, and how I must have it because triple negative breast cancer comes back with a vengeance and most times within two years; and it typically jumps to other organs such as the liver and brain, etc. I asked her about what chemotherapy would do to me and does it guarantee a cure. I asked her if it increases my chances for cancer in the future and what about damage to other organs and osteoporosis. She said chemo would lessen the chances of the cancer coming back within two years and could possibly stretch it to ten years before a possible reccurence. No guarantee of cure, just a delay of possible reccurrence. That, she said, outweighs the possible percentages of damage from the chemo. She said you will be sick and without an immune system for a while and lose your hair--the hair loss wasn't an issue for me as Authentic Tammy already took care of that (although, not for these circumstances). There are many more types of long-term effects, but not all were discussed. As we know in these current times, we only get 15 minutes with our doctors (it's not their faults--many would love to sit and help us--it's "the system"). New cancer patients are allowed 20-30 minutes for the first visit; and 15 minutes for follow-up appointments.
Everything moves so quickly. Patients don't get time to think. Upon leaving my appointments, the phone calls began. Genetics testing was scheduled, but would take 10 days for results. The surgeon's scheduler called to schedule surgery for THE VERY NEXT WEEK! I think, not! When I told her about waiting for genetic testing, it annoyed her to mess up the scheduling. I told her no earlier than 3 weeks from our conversation to allow for testing results and to allow for me, the patient, to get my head right and life in order. I chose to take control. It's my life.
Surgery was scheduled in Charlotte for November 19. The week of the surgery was full of appointments including Covid testing and placement of yet another metal clip which would be removed during surgery. This one made a beeping noise when used with a device. It let the surgeon know the area in which the cancer lies. I felt like a tracking device. There was literally a metal detector being waved across my breast and when detected, it beeped. Is there a better way to go about this? I don't know, but by the time I received this third placement of metal, I was feeling invaded and contaminated.
On November 19, 2021, I had my surgery which consisted of the removal of three lymph nodes (lymph node dissection) just beneath the armpit, and a lumpectomy to remove the cancer and surrounding tissue. As I look back on this now, it is overwhelming how lymph nodes are harvested and the repercussions that may take place afterwards, such as lymph fluid backup which may pool in the legs, arms, or area of dissection, resulting in the wearing of compression gear for some patients. The body is an amazing organism and the removal of anything, interrupts the flow of something else. It works like a machine doing and creating actions that we take for granted each day. The role of the lymphatic system is to transport lymph fluid containing infection-fighting white blood cells, throughout the body and removing toxins. The body is smart and accommodating at times. In the case of lymph node removal, for some patients, sometimes the fluid runs into a dead end at the removal site. Medical teams can assist with how to handle it when it happens; however, there is nothing to prevent it. And, of course, as with any surgery, the cutting of surface nerves which may or may not recover.
A day or two after surgery, my mother drove me to her house, near Lumberton, NC, where I would spend the first 10 days of recovery until my post-op appointments, after Thanksgiving. I'm not one to ask for help, but I'm learning. The lady who seemed to be able to do everything on her own, had to take a backseat to the lady who is granting herself some grace and allowing help to take over. I was grateful to be with my mother, and my daughter joined us for a few days as well. It's important to have a team to help you and to love up on you during this time.
Disclaimer: Although I am fascinated by the human body-especially the human brain; and although I have happily and excitedly spent years on learning, training, and on certifications regarding the human body, I am not a doctor-I could be if I could just figure out how to get past the math parts of it all! Seriously, speak with your healthcare provider before changing your healthcare plan or nutrition plan or your exercise plan. I am just providing knowledge. MyFit is not, nor is anyone that I mention in my blog, videos, or in my sessions, responsible for your health. I am not advising you to put any of this information into practice. These are my thoughts, my feelings, my journey. If you choose to implement or try any of it, it is at your own risk. The people and ideas that I speak of will be things that I believe in as I am always true to myself.